Personalising activity to target peak hyperglycaemia and improve cardiometabolic health in people with type 2 diabetes: protocol for a randomised controlled trial.

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  • Additional Information
    • Source:
      Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE
    • Publication Information:
      Original Publication: [London] : BMJ Publishing Group Ltd, 2011-
    • Subject Terms:
      Cardiovascular Diseases*/complications ; Diabetes Mellitus, Type 2*/complications ; Diabetes Mellitus, Type 2*/therapy ; Hyperglycemia*/complications ; Hyperglycemia*/prevention & control; Australia ; Blood Glucose ; Glycated Hemoglobin/analysis ; Humans ; Randomized Controlled Trials as Topic
    • Abstract:
      Introduction: The benefits of physical activity for glycaemic control in type 2 diabetes (T2D) are well-known. However, whether established glycaemic and cardiovascular benefits can be maximised by exercising at a certain time of day is unknown. Given postprandial glucose peaks contribute to worsening glycated haemoglobin (HbA1c) and cardiovascular risk factors, and that exercise immediately lowers blood glucose, prescribing exercise at a specific time of day to attenuate peak hyperglycaemia may improve glycaemic control and reduce the burden of cardiovascular disease in people with T2D.
      Methods and Analysis: A single-centre randomised controlled trial will be conducted by the University of Wollongong, Australia. Individuals with T2D (n=70, aged 40-75 years, body mass index (BMI): 27-40 kg/m 2 ) will be recruited and randomly allocated (1:1), stratified for sex and insulin, to one of three groups: (1) exercise at time of peak hyperglycaemia (ExPeak, personalised), (2) exercise not at time of peak hyperglycaemia (NonPeak) or (3) waitlist control (WLC, standard care). The trial will be 5 months, comprising an 8-week intervention and 3-month follow-up. Primary outcome is the change in HbA1c preintervention to postintervention. Secondary outcomes include vascular function (endothelial function and arterial stiffness), metabolic control (blood lipids and inflammation) and body composition (anthropometrics and dual-energy X-ray absorptiometry (DEXA)). Tertiary outcomes will examine adherence.
      Ethics and Dissemination: The joint UOW and ISLHD Ethics Committee approved protocol (2019/ETH09856) prospectively registered at the Australian New Zealand Clinical Trials Registry. Written informed consent will be obtained from all eligible individuals prior to commencement of the trial. Study results will be published as peer-reviewed articles, presented at national/international conferences and media reports.
      Trial Registration Number: ACTRN12619001049167.
      Competing Interests: Competing interests: None declared.
      (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
    • References:
      J Biomed Inform. 2009 Apr;42(2):377-81. (PMID: 18929686)
      Med Sci Sports Exerc. 2001 Jun;33(6 Suppl):S438-45; discussion S452-3. (PMID: 11427768)
      Diabetes Res Clin Pract. 2008 Nov;82(2):262-7. (PMID: 18950890)
      Exerc Sport Sci Rev. 2019 Jan;47(1):22-28. (PMID: 30334851)
      Med Sci Sports Exerc. 2018 Dec;50(12):2387-2397. (PMID: 30067587)
      Diabetes Res Clin Pract. 2019 Nov;157:107843. (PMID: 31518657)
      Int J Clin Pract. 2010 Nov;64(12):1705-11. (PMID: 20860758)
      Vasc Med. 2013 Dec;18(6):354-65. (PMID: 24172228)
      Hypertension. 2011 Mar;57(3):363-9. (PMID: 21263128)
      JAMA. 2011 May 4;305(17):1790-9. (PMID: 21540423)
      Diabetes. 2005 Jan;54(1):1-7. (PMID: 15616004)
      J Biomed Inform. 2019 Jul;95:103208. (PMID: 31078660)
      Diabetes Care. 1990 Feb;13(2):172-5. (PMID: 2351014)
      Am J Physiol Heart Circ Physiol. 2002 Oct;283(4):H1354-60. (PMID: 12234785)
      Arch Public Health. 2015 Sep 25;73:43. (PMID: 26413295)
      Vascul Pharmacol. 2006 Nov;45(5):277-80. (PMID: 17011834)
      J Physiol. 2001 Sep 1;535(Pt 2):313-22. (PMID: 11533125)
      JAMA. 2021 Jul 20;326(3):257-265. (PMID: 34152382)
      Eur Heart J. 2019 Aug 7;40(30):2534-2547. (PMID: 31211361)
      Med Sci Sports Exerc. 2002 Dec;34(12):2057-61. (PMID: 12471316)
      Br J Sports Med. 2014 Mar;48(5):404-6. (PMID: 23632744)
      Sports Med. 2018 Jun;48(6):1479-1491. (PMID: 29396781)
      Horm Metab Res. 2007 Sep;39(9):683-6. (PMID: 17846977)
      Med Sci Sports Exerc. 2020 Feb;52(2):323-334. (PMID: 31479004)
      Circulation. 2002 Sep 3;106(10):1211-8. (PMID: 12208795)
      Pulse (Basel). 2017 Jan;4(4):180-192. (PMID: 28229053)
      Diabetes Res Clin Pract. 2021 Jun;176:108841. (PMID: 33933500)
      Front Physiol. 2017 Jul 25;8:528. (PMID: 28790929)
      Am J Physiol Heart Circ Physiol. 2016 Nov 1;311(5):H1258-H1267. (PMID: 27638878)
      Exerc Sport Sci Rev. 2007 Oct;35(4):192-6. (PMID: 17921788)
      Cardiovasc Diabetol. 2018 Dec 3;17(1):153. (PMID: 30509271)
      Diabetes. 2009 Apr;58(4):773-95. (PMID: 19336687)
      Br J Sports Med. 2020 Dec;54(24):1451-1462. (PMID: 33239350)
      Diabetologia. 2019 Feb;62(2):233-237. (PMID: 30426166)
      Nutrients. 2020 Apr 29;12(5):. (PMID: 32365563)
      Diabetes Care. 2017 Jul;40(7):813-820. (PMID: 28637886)
      Diabetes Care. 2010 Aug;33(8):1905-7. (PMID: 20668158)
    • Contributed Indexing:
      Keywords: clinical physiology; complementary medicine; diabetic nephropathy & vascular disease; hypertension; physiology; sports medicine
    • Molecular Sequence:
      ANZCTR ACTRN12619001049167
    • Accession Number:
      0 (Blood Glucose)
      0 (Glycated Hemoglobin A)
    • Publication Date:
      Date Created: 20220330 Date Completed: 20220421 Latest Revision: 20221207
    • Publication Date:
      20240628
    • Accession Number:
      PMC8966572
    • Accession Number:
      10.1136/bmjopen-2021-057183
    • Accession Number:
      35351723